Provider Demographics
NPI:1649870775
Name:ZHOU, QING
Entity type:Individual
Prefix:
First Name:QING
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7004 SOUTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5467
Mailing Address - Country:US
Mailing Address - Phone:703-581-8686
Mailing Address - Fax:
Practice Address - Street 1:8386 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-3428
Practice Address - Country:US
Practice Address - Phone:703-330-2455
Practice Address - Fax:703-330-6035
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist